Abstract
1 The clinical pharmacology of labetalol has been evaluated using pharmacological and physiological test methods.
2 Labetalol displaces the log dose-response curves to the right of isoprenaline-induced increases in heart rate, cardiac output and decreases in diastolic BP. The similarity in the displacements of these curves suggests labetalol has non-selective β-adrenoceptor-blocking properties.
3 Labetalol inhibits exercise-induced increases in heart rate and systolic BP, inhibits tilt tachycardia and that associated with Valsalva's manoeuvre.
4 Direct comparison with propranolol using the methods above have shown that the β-adrenoceptor-blocking effect of labetalol is qualitatively similar to that of propranolol but that propranolol is more potent weight for weight to the order of 4 to 6:1 propranolol:labetalol. In respect of their effects on respiratory function, labetalol and propranolol are qualitatively different; whereas propranolol increases airways resistance in equipotent β-adrenoceptor-blocking doses, labetalol does not.
5 Labetalol displaces the log dose-response curves of phenylephrine and noradrenaline-induced increases in systolic and diastolic BPs to the right consistent with an α-adrenoceptor-blocking action.
6 Labetalol inhibits increases in BP due to a cold stimulus, whereas propranolol does not.
7 The combined α- and β-adrenoceptor-blocking effect of labetalol after acute and chronic administration leads to reductions in BP and peripheral resistance but little change in heart rate or cardiac output at rest. During exercise, increases in BP and heart rate are attenuated but cardiac output increases are only significantly diminished at high levels of exercise.
8 Labetalol is less lipophylic than propranolol, with a partition coefficient of 1.2. It is almost completely metabolized being extensively conjugated.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beilin L. J., Juel-Jensen B. E. Alpha and beta adrenergic blockade in hypertension. Lancet. 1972 May 6;1(7758):979–982. doi: 10.1016/s0140-6736(72)91154-3. [DOI] [PubMed] [Google Scholar]
- Blakeley A. G., Summers R. J. The effects of labetalol (AH 5158) on adrenergic transmission in the cat spleen. Br J Pharmacol. 1977 Apr;59(4):643–650. doi: 10.1111/j.1476-5381.1977.tb07733.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Boakes A. J., Knight E. J., Prichard B. N. Preliminary studies of the pharmacological effects of 5-[1-hydroxy-2-((1-methyl-3-phenylpropyl)amino)-ethyl] salicylamide (AH 5158) in man. Clin Sci. 1971 Apr;40(4):18P–19P. doi: 10.1042/cs040018pa. [DOI] [PubMed] [Google Scholar]
- Collier J. G., Dawnay N. A., Nachev C., Robinson B. F. Clinical investigation of an antagonist at alpha- and beta-adrenoceptors-AH5158A. Br J Pharmacol. 1972 Feb;44(2):286–293. doi: 10.1111/j.1476-5381.1972.tb07265.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dawson A., Smith I., Johnson B. F. The transient anti-hypertensive effect of phentolamine in patients receiving beta-blocker treatment. J Int Med Res. 1977;5(6):462–464. doi: 10.1177/030006057300100214. [DOI] [PubMed] [Google Scholar]
- Edwards R. C., Raftery E. B. Haemodynamic effects of long-term oral labetalol. Br J Clin Pharmacol. 1976 Aug;3(4 Suppl 3):733–736. [PubMed] [Google Scholar]
- Farmer J. B., Kennedy I., Levy G. P., Marshall R. J. Pharmacology of AH 5158; a drug which blocks both - and -adrenoceptors. Br J Pharmacol. 1972 Aug;45(4):660–675. doi: 10.1111/j.1476-5381.1972.tb08125.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Koch G. Acute hemodynamic effects of an alpha- and beta-receptor blocking agent (AH 5158) on the systemic and pulmonary circulation at rest and during exercise in hypertensive patients. Am Heart J. 1977 May;93(5):585–591. doi: 10.1016/s0002-8703(77)80008-2. [DOI] [PubMed] [Google Scholar]
- Kumana C. R., Marlin G. E., Kaye C. M., Smith D. M. New approach to assessment of cardioselectivity of beta-blocking drugs. Br Med J. 1974 Nov 23;4(5942):444–447. doi: 10.1136/bmj.4.5942.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maconochie J. G., Richards D. A., Woodings E. P. Modification of pressor responses induced by 'cold' [proceedings]. Br J Clin Pharmacol. 1977 Jun;4(3):389P–389P. [PubMed] [Google Scholar]
- Maconochie J. G., Woodings E. P., Richards D. A. Effects of labetalol and propranolol on histamine-induced bronchoconstriction in normal subjects. Br J Clin Pharmacol. 1977 Apr;4(2):157–162. doi: 10.1111/j.1365-2125.1977.tb00688.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Majid P. A., Meeran M. K., Benaim M. E., Sharma B., Taylor S. H. Alpha- and beta-adrenergic receptor blockade in the treatment of hypertension. Br Heart J. 1974 Jun;36(6):588–596. doi: 10.1136/hrt.36.6.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martin L. E., Hopkins R., Bland R. Metabolism of labetalol by animals and man. Br J Clin Pharmacol. 1976 Aug;3(4 Suppl 3):695–710. [PubMed] [Google Scholar]
- McDevitt D. G. The assessment of beta-adrenoceptor blocking drugs in man. Br J Clin Pharmacol. 1977 Aug;4(4):413–425. doi: 10.1111/j.1365-2125.1977.tb00756.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mehta J., Cohn J. N. Hemodynamic effects of labetalol, an alpha and beta adrenergic blocking agent, in hypertensive subjects. Circulation. 1977 Feb;55(2):370–375. doi: 10.1161/01.cir.55.2.370. [DOI] [PubMed] [Google Scholar]
- Prichard B. N., Ross E. J. Use of propranolol in conjunction with alpha receptor blocking drugs in pheochromocytoma. Am J Cardiol. 1966 Sep;18(3):394–398. doi: 10.1016/0002-9149(66)90061-0. [DOI] [PubMed] [Google Scholar]
- Prichard B. N. The second Lilly Prize Lecture, University of Newcastle, July 1977. beta-Adrenergic receptor blockade in hypertension, past, present and future. Br J Clin Pharmacol. 1978 May;5(5):379–399. doi: 10.1111/j.1365-2125.1978.tb01644.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Prichard B. N., Thompson F. O., Boakes A. J., Joekes A. M. Some haemodynamic effects of compound AH 5158 compared with propranolol, propranolol plus hydrallazine, and diazoxide: the use of AH 5158 in the treatment of hypertension. Clin Sci Mol Med Suppl. 1975 Jun;2:97s–100s. doi: 10.1042/cs048097s. [DOI] [PubMed] [Google Scholar]
- Richards D. A., Maconochie J. G., Bland R. E., Hopkins R., Woodings E. P., Martin L. E. Relationship between plasma concentrations and pharmacological effects of labetalol. Eur J Clin Pharmacol. 1977 Jan 3;11(2):85–90. doi: 10.1007/BF00562897. [DOI] [PubMed] [Google Scholar]
- Richards D. A. Pharmacological effects of labetalol in man. Br J Clin Pharmacol. 1976 Aug;3(4 Suppl 3):721–723. [PubMed] [Google Scholar]
- Richards D. A., Prichard B. N., Boakes A. J., Tuckman J., Knight E. J. Pharmacological basis for antihypertensive effects of intravenous labetalol. Br Heart J. 1977 Jan;39(1):99–106. doi: 10.1136/hrt.39.1.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Richards D. A., Prichard B. N., Dobbs R. J. Adrenoceptor blockade of the circulatory responses to intravenous isoproterenol. Clin Pharmacol Ther. 1978 Sep;24(3):264–273. doi: 10.1002/cpt1978243264. [DOI] [PubMed] [Google Scholar]
- Richards D. A., Prichard B. N., Hernández R. Circulatory effects of noradrenaline and adrenaline before and after labetalol. Br J Clin Pharmacol. 1979 Apr;7(4):371–378. [PMC free article] [PubMed] [Google Scholar]
- Richards D. A., Tuckman J., Prichard B. N. Assessment of alpha- and beta-adrenoceptor blocking actions of labetalol. Br J Clin Pharmacol. 1976 Oct;3(5):849–855. doi: 10.1111/j.1365-2125.1976.tb00637.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Richards D. A., Woodings E. P., Maconochie J. G. Comparison of the effects of labetalol and propranolol in healthy men at rest and during exercise. Br J Clin Pharmacol. 1977 Feb;4(1):15–21. doi: 10.1111/j.1365-2125.1977.tb00660.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Richards D. A., Woodings E. P., Prichard B. N. Circulatory and alpha-adrenoceptor blocking effects of phentolamine. Br J Clin Pharmacol. 1978 Jun;5(6):507–513. doi: 10.1111/j.1365-2125.1978.tb01665.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Skinner C., Gaddie J., Palmer K. N. Comparison of intravenous AH 5158 (ibidomide) and propranolol in asthma. Br Med J. 1975 Apr 12;2(5962):59–61. doi: 10.1136/bmj.2.5962.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
